Background Existing data on basal cell carcinoma (BCC) clearance rates are predominantly derived from histological sampling or retrospective analyses. Prospective evaluations of clinical clearance remain limited. This study prospectively assessed long-term clinical clearance and scar outcomes following treatment of BCC with a 1064 nm Nd:YAG laser. Methods A total of 34 BCC lesions were treated using a 1064 nm Nd:YAG laser and evaluated at approximately 6 and 12 months post-treatment.